北京协和医院17种国家医保谈判抗癌药临床应用情况调查  

Investigation on the Clinical Use of 17 Antineoplastic Drugs Passing National Medical Insurance Negotiation in Peking Union Medical College Hospital

作　　者：孙雯娟[1] 唐彦[1] 邹羽真[1] 张谦[1] 张波[1] 杜小莉[1] SUN Wenjuan;TANG Yan;ZOU Yuzhen;ZHANG Qian;ZHANG Bo;DU Xiaoli(Department of Pharmacy,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院,北京协和医学院,北京协和医院药剂科,北京100730

出　　处：《协和医学杂志》2021年第6期958-964,共7页Medical Journal of Peking Union Medical College Hospital

基　　金：北京药学会临床药学研究项目(2019年)。

摘　　要：目的了解国家卫生行政部门发布17种国家医保谈判抗癌药相关政策前后,北京协和医院相关药品的临床应用情况及变化趋势,以期为医院药品目录优化与调整提供参考。方法收集并分析2017年12月1日至2019年11月30日(2017年12月1日至2018年11月30日为2018年度,2018年12月1日至2019年11月30日为2019年度)北京协和医院17种抗癌药的全部门诊及住院处方数据。对患者基本信息、用药数量、用药金额、用药频度、限定日费用等进行统计分析。结果2019年度共6881例患者使用此17种抗癌药。其中,门诊患者4713例(68.5%),住院患者2168例(31.5%)。17种抗癌药用药金额占本院全部抗癌药用药金额、全部药品用药金额的比率分别为16.3%和3.8%;用药金额排名前3位的病种分别为胸部肿瘤、血液肿瘤和泌尿系统肿瘤;用药金额排名前3位的药物分别为奥希替尼、奥曲肽微球、克唑替尼,且用药金额与用药频度同步性好;限定日费用排名前3位的药物分别为维莫非尼、西妥昔单抗和伊布替尼。政策实施前已入院的6种抗癌药中,2019年度用药金额和处方量分别同比增加78.2%、89.8%;用药金额占本院全部抗癌药用药金额、全部药品用药金额的比率分别同比增加54.4%、78.6%;与2018年度相比,2019年度奥希替尼用量与用药金额均大幅增加,西妥昔单抗、阿昔替尼、舒尼替尼及奥曲肽微球用量增加而用药金额下降,培门冬酶用量和用药金额均显著下降。结论国家医保谈判政策促进了17种抗癌药在临床的使用,提高了用药可及性,亦导致药品费用有较大幅度增加。应加强对相关药品的临床应用监测和动态评估,在保障患者用药需求的同时促进合理用药。Objective The aim of this study is to investigate the clinical use of 17 antineoplastic drugs passing national medical insurance negotiation in Peking Union Medical College Hospital before and after the im⁃plementation of national policies about promoting the inclusion of antineoplastic drugs in health insurance,and to provide reference for the optimization and adjustment of hospital formulary.Methods The prescription data of 17 antineoplastic drugs of outpatients and inpatients in our hospital from December 1,2017 to November 30,2019(December 1,2017 to November 30,2018 for the year 2018,December 1,2018 to November 30,2019 for the year 2019)were collected.The basic information of patients,the usage amount and cost,defined daily doses(DDDs),and defined daily cost(DDC)were analyzed.Results A total of 6881 patients used the 17 antineo⁃plastic drugs in 2019.Among them,there were 4713(68.5%)outpatients and 2168(31.5%)inpatients.The proportions of the cost of 17 antineoplastic drugs to that of all antineoplastic drugs and all formulary drugs in our hospital were 16.3%and 3.8%,respectively.The 17 antineoplastic drugs were mainly used for thorax,hemato⁃logic,and urologic malignancies.The top three antineoplastic drugs in terms of cost were osimertinib,octreotide acetate microspheres and crizotinib,with good synchronization between drug cost and DDDs.The top three drugs in terms of DDC were vemurafenib,cetuximab and ibrutinib.The total cost and prescription of the six drugs that had already been included in the formulary of our hospital before the implementation of the policy increased by 78.2%and 89.8%,respectively in 2019 compared with those in 2018,and the proportions of the cost of six an⁃tineoplastic drugs to that of all antineoplastic drugs and all formulary drugs in the hospital increased by 54.4%and 78.6%,respectively.After the implementation of national policies,the quantity and cost of osimertinib in⁃creased significantly,and the drugs increased in quantity but decreased in cost were cetuximab,axitinib

关 键 词：抗癌药 临床应用 国家医保谈判 用药频度 用药金额 

分 类 号：R95[医药卫生—药学]